Lellouch A
Centre Hospitalier de Saint-Germain-en-Laye, Département d'Information Médicale, St-Germain-en-Laye.
Rev Neurol (Paris). 1994 Aug-Sep;150(8-9):506-10.
Nowadays, one hundred years following Charcot's death (1893), neurologists remember his original contributions in the field of neurological disorders. The aim of this work is to assess the extraordinary Charcot's ability to create new diseases outside the field of neurology, mainly in internal medicine and in geriatric disorders. A good way to evaluate his abilities is to compare the state of medical knowledge before and after Charcot. Before, "chronic rheumatic disease" was not distinguished from gout and shaking falsy was confused with other tremors occurring in the elderly. Among vascular cerebral diseases ("apoplexy"), physicians could not recognize those following a bleeding process from those induced by an ischaemic brain disease. After Charcot's papers, these various disorders were better known and well defined from their pathology, aetiology and mechanisms. According to his obsessive personality, Charcot liked classifying and labeling diseases. Some nosographic frameworks were nevertheless inappropriate. Thus, in the field of joint disorders, Charcot included in the same pathological entity ("chronic rheumatic disease") various arthropathies such as rheumatic arthritis and osteo-arthritis. In France, this mistake hindered the understanding of the mechanism of these diseases. Though Charcot made mistakes when he described new pathological disorders, these mistakes were of little consequence, compared to the importance of his main nosologic contributions. As a whole, Charcot's scientific methodology seemed to be accurate and successful.
如今,在夏科(Charcot)逝世(1893年)一百年后,神经科医生铭记着他在神经系统疾病领域的开创性贡献。本文旨在评估夏科在神经学领域之外创造新疾病的非凡能力,主要涉及内科医学和老年疾病。评估他能力的一个好方法是比较夏科前后医学知识的状况。此前,“慢性风湿性疾病”与痛风未作区分,震颤谵妄与老年人出现的其他震颤相混淆。在脑血管疾病(“中风”)中,医生无法区分出血性疾病与缺血性脑疾病引发的疾病。在夏科发表论文之后,这些不同的疾病从病理学、病因学和发病机制方面得到了更好的了解和明确界定。出于其偏执的性格,夏科喜欢对疾病进行分类和命名。然而,有些疾病分类框架并不恰当。因此,在关节疾病领域,夏科将各种关节病,如风湿性关节炎和骨关节炎,归入同一个病理实体(“慢性风湿性疾病”)。在法国,这一错误阻碍了对这些疾病发病机制的理解。尽管夏科在描述新的病理疾病时犯了错误,但与他主要的疾病分类学贡献相比,这些错误微不足道。总体而言,夏科的科学方法似乎准确且成功。